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“Association between congenital nasolacrimal duct obstruction and mode of delivery at birth”
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Aim To investigate the association between the incidence of congenital nasolacrimal duct obstruction (CNDO) and delivery by caesarean section or spontaneous vaginal labour.
Methods A total of 40 patients who were diagnosed as CNDO and treated with lacrimal probing between January 2011 and February 2013 were reviewed retrospectively. The patients were divided into two groups: group 1 (caesarean section delivery) and group 2 (spontaneous vaginal delivery).
Results A total of 22 patients delivered by caesarean section (group 1) were compared with 18 patients delivered by spontaneous vaginal labour. There were 10 male (45%), 12 female (55%) patients in group 1 and nine (50 %) males, nine females (50 %) patients in group 2. The mean age of group 1 was 14.85 months (12-22 month) and group 2 was 15.20 months (12-23 month). Mean birth time was 38.1 week (36-40 week) in group 1 and 39.4 week (38-41 week) in group 2. There was no statistically significant difference between the age, gender and birth time between the groups (p>0.05). There was no statistically significant difference between the way of delivery (caesarean section or spontaneous vaginal delivery) and the incidence of CNDO (p>0.05).
Conclusion Congenital nasolacrimal duct obstruction was found less frequently among the patients delivered by vaginal delivery comparing to the patients with caesarean delivery, however this difference was not statistically significant. It is considered that, with the studies which include more patients, the difference may become significant.
Purpose:
To investigate the association between mode of delivery, incidence of congenital nasolacrimal duct obstruction (CNLDO), and treatment outcomes.
Methods:
The medical records of children diagnosed with CNLDO at a tertiary referral center between 2012 and 2017 were analyzed retrospectively. Patient demographics, pregnancy and birth history, clinical characteristics of CNLDO, and treatment outcomes were compared in patients delivered via Cesarean section (CS) versus vaginal delivery (VD). The rates of CS, as well as full-term and premature births, were also compared to Miami-Dade County normative values to eliminate the confounding effects of prematurity.
Results:
A total of 104 patients were included. A significantly higher percentage of patients with CNLDO (61%) were delivered via CS (P < 0.0001). Among full-term babies, there was 55% greater risk (OR = 1.55; 95% CI, 0.98-2.43; P = 0.067) of CNLDO for CS birth compared to all other babies. Among preterm babies, there were no significantly greater odds of CNLDO for CS compared to VD births (P = 0.575). CNLDO did not resolve spontaneously in 50 patients, including 37 CS (74%) and 13 VD (26%) patients (P = 0.007). Among those patients who failed first-line probing, 86.2% were born via CS, whereas 13.8% were born via VD (P = 0.0009).
Conclusions:
CS is a risk factor for CNLDO, independent of gestational age. Children born via CS also tend to have a more complicated clinical course requiring additional surgical interventions.
Background/aims
The literature on the prevalence and demographics of congenital nasolacrimal duct obstruction (CNLDO) is 30–70 years old and largely comprises small sample sizes. This study provides epidemiological findings of this common disorder from the largest cohort reported to date.
Methods
The medical records of all children (<5 years of age) residing in Olmsted County, Minnesota, when diagnosed with CNLDO from 1 January 1995 through 31 December 2004, were reviewed.
Results
Of 17 713 newborns born during the 10-year study period, 1998 were diagnosed with CNLDO, yielding a birth prevalence of one in nine live births. The diagnosis was made in approximately 90% by a primary care physician, at a median age of 5 weeks, with no gender predilection. Compared with the reference population, CNLDO was associated with premature birth (p=0.005) and was more prevalent among Caucasians (p<0.001). Two-thirds of patients initially presented with discharge alone, 18% with tearing alone and 15% with both discharge and tearing.
Conclusions
In this large population-based cohort, CNLDO occurred in one in nine live births with no gender predilection. Prematurity and Caucasian race were associated with the development of CNLDO. Mucopurulent discharge was a much more common feature than tearing at initial presentation.
Purpose:
To assess the association of congenital nasolacrimal duct obstruction (CNLDO) with mode of birth (vaginal or cesarean).
Methods:
This study was a prospective interventional case series of 200 consecutive cases of CNLDO presenting at a tertiary care center. Data collected include demographics, mode of delivery, elective or emergency cesarean section, primary or secondary cesarean sections, type of CNLDO (simple or complex), management, and outcomes. Statistical significance was set at a P value of less than .05.
Results:
Of the 200 consecutive patients, 97 (48.5%) were vaginal deliveries and 103 (51.5%) were cesarean sections. Of the 103 cesarean section patients, 57 (55.3%) were primary cesarean sections and the remaining were secondary cesarean sections. Based on the type of CNLDO, 172 (86%) were simple CNLDO. In general, the current study did not find any significant association between the incidence of CNLDO and mode of delivery. Among the complex CNLDO cohort (n = 28), a significant association was found with cesarean section delivery (P = .016); however, no such association was noted when the patients were analyzed with regard to their age at presentation.
Conclusion:
The current study did not find an overall significant association between CNLDO and the mode of delivery; however, the subset of patients with complex CNLDO showed a significant association with cesarean section. [J Pediatr Ophthalmol Strabismus. 200X;XX(X):XX-XX.].
Objective:
Congenital nasolacrimal duct obstruction (CNDO) is the most common cause of neonatal epiphora. Persistence can lead to chronic dacryocystitis and amblyopia. This study analyzed the association between the incidence of CNDO and delivery by cesarean section.
Study design:
This was a retrospective cohort study of 386 children with CNDO (born between 2000 and 2008). The incidence of the delivery mode in patients with CNDO was compared with data from a corresponding population derived from annual birth statistics.
Results:
There was no statistically significant association between the overall cesarean section rate and the incidence of CNDO, but primary cesarean section was significantly more frequent among patients with CNDO (73.15%, p < 0.05). The difference was significant for both genders for the period from 2000 to 2008 (p < 0.05%). The relative risk for CNDO was 1.7-fold increased in children delivered by primary cesarean section.
Conclusion:
Primary cesarean section may be a risk factor for CNDO.
American Association for Pediatric Ophthalmology and Strabismus
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